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A head injury is a broad term that describes a vast array of injuries that occur to the scalp, skull, brain, and underlying tissue and blood vessels in the head. Head injuries are also commonly referred to as brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma.
Head injuries are one of the most common causes of disability and death in adults. The injury can be as mild as a bump, bruise (contusion), or cut on the head, or can be moderate to severe in nature due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain.
The following are some of the different types of head injuries:
There are many causes of head injury in children and adults. The most common traumatic injuries are from motor vehicle accidents (automobiles, motorcycles, or struck as a pedestrian), from violence, from falls, or as a result of child abuse. Subdural hematomas and brain hemorrhages can sometimes happen spontaneously.
When there is a direct blow to the head, shaking of the child, or when a whiplash-type injury occurs, the brain jolts backwards and hits the skull on the opposite side, causing a bruise. The jarring of the brain against the sides of the skull can cause tearing of the internal lining, tissues, and blood vessels that may cause internal bleeding, bruising, or swelling of the brain.
Young children, older adults and males are at most risk for head injuries. Those who don’t use child car seats, seat belts, or safety helmets are also at increased risk for head injuries.
Symptoms vary depending on the severity of the head injury. The following are the most common symptoms of a head injury. However, each person may experience symptoms differently. Symptoms may include:
The symptoms of a head injury may resemble other problems or medical conditions. Always consult your health care provider for a diagnosis.
The full extent of the head injury may not be completely understood immediately after the injury. A comprehensive evaluation and testing are needed. The diagnosis of a head injury is made with a physical exam and diagnostic tests. During the exam, the health care provider will ask about your medical history and how the injury occurred. Trauma to the head can cause neurological problems and may require further medical follow up.
Diagnostic tests may include:
Specific treatment of a head injury will be determined by your health care provider based on:
Depending on the severity of the injury, treatment may range from ice and rest to observation to surgery.
Treatment is individualized, depending on the extent of the condition and the presence of other injuries. For a severe head injury, you would be monitored for increased intracranial pressure (pressure inside the skull). Head injury may cause the brain to swell. Since the brain is covered by the skull, there is only a small amount of room for it to swell. This causes pressure inside the skull to increase, which can lead to brain damage.
Intracranial pressure is measured in two ways. One way is to place a small hollow tube (catheter) into the fluid-filled space in the brain (ventricle). Other times, a small, hollow device (bolt) is placed through the skull into the space just between the skull and the brain. Both devices are inserted by the doctor either in the intensive care unit (ICU) or in the operating room. The ICP device is then attached to a monitor that gives a constant reading of the pressure inside the skull. If the pressure goes up, it can be treated right away. While the ICP device is in place, you will be given medication to stay comfortable. When the swelling has gone down and there is little chance of more swelling, the device will be removed.
A head injury can result in loss of muscle strength, fine motor skills, speech, vision, hearing, or taste function, depending on the brain region involved and the severity of brain damage. Long- or short-term changes in personality or behavior may also occur. Long-term medical and rehabilitative (physical, occupational, or speech therapy) management may be needed.
The key to head injury prevention is to promote a safe environment for children and adults and to prevent head injuries from occurring in the first place. The following measures can help prevent head injury:
Your recovery depends on the type of brain injury and other medical problems that may be present. It is important to focus on maximizing your capabilities at home and in the community.
Prompt medical attention should be sought if any of the following occur
Prevention is most important by promoting a safe environment for children and adults through the use of car seats, seat belts, and helmets, and removing tripping and fall hazards in the home.
Tips to help you get the most from a visit to your health care provider:
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.